Proposed Models to Integrate Medicare and Medicaid Benefits for Dual Eligibles: A Look at the 15 State Design Contracts Funded By CMS

Aug 12, 2011

This brief summarizes 15 states’ preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the federal Center for Medicare and Medicaid Innovation (CMMI), are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million “dual eligibles,” whose medical needs and health care costs typically exceed those of other Medicare and Medicaid beneficiaries.

The concepts contained in these initial proposals are expected to change and develop as states progress through the design process, and the Centers for Medicare and Medicaid Services determines which proposals will be implemented. The brief summarizes proposals from California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington, and Wisconsin.